Terra Bernardo Barcellos, Moraes Eduardo Wanzenboeck, de Souza Alceuleir Cardoso, Cavatte José Maria, Teixeira João Carlos de Medeiros, De Nadai Anderson
Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil.
Rev Bras Ortop. 2015 Sep 8;50(5):607-12. doi: 10.1016/j.rboe.2015.08.014. eCollection 2015 Sep-Oct.
Synovial osteochondromatosis is a benign proliferative disorder with metaplasia of the synovial membrane that affects the fibroblasts of the synovial joints, tendons and bursae. In literature, there are few descriptions of synovial osteochondromatosis of the elbow. The objective of this article was to report a case of synovial osteochondromatosis of the elbow in a patient aged 32, basketball athlete, in which surgical treatment was chosen because of the pain and functional limitation and stage of disease with multiple loose bodies. Patient 32, male, presented with pain and limitation of motion of the elbow. The range of passive motion was 100° of flexion and 30° extension. The range of active motion was 40-90°. Magnetic resonance observed many loose bodies mainly in the posterior compartment in the olecranon fossa plus some chondral lesions in the capitellum. The arthroscopic treatment was chosen with two anteriors portals (medial and lateral) and two posterior portals (standard posterior and posterolateral) for easing loose bodies and osteoplasty of the olecranon fossa. The visual analog scale pain was 9-3 and its arc of active motion was 110° to -20° of flexion and extension. On a scale of performance from Mayo Clinic patients was 65 points preoperatively to 90 postoperatively with 9 months follow-up and the patient was satisfied with the treatment outcome. Arthroscopic treatment of synovial osteochondromatosis of the elbow is an effective and safe therapeutic management with low morbidity and early return to activities.
滑膜骨软骨瘤病是一种良性增生性疾病，伴有滑膜化生，可影响滑膜关节、肌腱和滑囊的成纤维细胞。在文献中，关于肘部滑膜骨软骨瘤病的描述很少。本文的目的是报告一例32岁男性篮球运动员肘部滑膜骨软骨瘤病的病例，该患者因疼痛、功能受限以及疾病处于伴有多个游离体的阶段而选择手术治疗。患者为32岁男性，表现为肘部疼痛和活动受限。被动活动范围为屈曲100°、伸展30°。主动活动范围为40 - 90°。磁共振成像观察到许多游离体，主要位于鹰嘴窝后室，以及肱骨小头的一些软骨损伤。选择关节镜治疗，采用两个前入路（内侧和外侧）和两个后入路（标准后入路和后外侧入路），以取出游离体并对鹰嘴窝进行骨成形术。视觉模拟评分法疼痛评分从9分降至3分，主动活动弧为屈曲110°至伸展 - 20°。根据梅奥诊所的患者表现评分，术前为65分，术后9个月随访时为90分，患者对治疗结果满意。关节镜治疗肘部滑膜骨软骨瘤病是一种有效且安全的治疗方法，发病率低，能早期恢复活动。
